Comparative acceptability of first-line antidepressants among older adults using filled prescription sequences: A nationwide cohort study

OBJECTIVE: Differences in the effectiveness of antidepressant medications by age are uncertain, with no compelling evidence of medication outperforming others in older adults. This real-world study compared the acceptability (efficacy and tolerability) of 20 antidepressants in younger and older patients using filled prescription sequences. MATERIAL AND METHODS: A nationwide cohort from the French national health system (SNDS) identified new antidepressant users over one year. The primary outcome was clinical acceptability, measured by the continuation/change ratio over the six-month period after initiating first-line treatment. Continuation was defined as at least two refills of the same treatment. Change was defined as at least one filled prescription of another antidepressant, an antipsychotic medication, or a mood-stabilizer. Antidepressant medications were compared by clinical acceptability while stratifying on age (